A controversial ad campaign shows a blood-covered girl holding a menstrual cup, and critics say it makes the issue worse

• A new ad campaign, featuring a girl holding a menstrual cup with her face covered in blood, has prompted confusion and anger online.
• The company behind it, which advocates for people with disabilities, said the ad is intended to end shame and stigma around menstruation and recognize a need for accessible menstrual products.
• Opponents say it relies on shock value, reinforces stereotypes about women and menstruation being "unclean," and unethically portrays a girl with a disability. 
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The image is startling — a girl with half her face covered in blood. A double-take reveals it's menstrual blood since the bottom half of the photo shows the girl, who is missing fingers, holding a menstrual cup, which is an alternative to a tampon or pad. 

The image, featured on a billboard in Kenya, is part of an ad campaign by This Ability, a Kenyan advocacy organization for people with disabilities, especially women and girls. 

The caption #EndPeriodStigma, and online commentary on the ad, suggest it's intended to make people confront their discomfort around menstruation, and consider how to make sanitary products more accessible for everyone. 

But instead, it's prompted confusion and anger online, where people say the ad does just the opposite: Rather than making menstruation more acceptable, it uses shock value to attract attention, tokenizes the girl in the picture, and evokes stereotypes of periods (and women) as unclean.

"This ad is the most irresponsible way to address menstrual taboos," Dr. Stellah Wairimu Bosire, a Kenyan physician and gender equality activist, told Insider. "Their thoughts are in the right place, but they portrayed it wrongly."

The campaign's intentions are to normalize menstruation, particularly for women and girls with disabilities

In September, a 14-year-old Kenyan girl killed herself after being shamed by her teacher for having her period. Her death prompted advocates to speak out against period-shaming and work to reduce stigma.

But women and girls with disabilities were still left out of that conversation, according to a statement This Ability sent Insider via email. So the organization launched the recent ads bring awareness to the complications those women and girls face in accessing and using menstrual products not designed with them in mind, the statement said. 

"The reality is that there is a distinct invisibility of the sexual and reproductive rights of women and girls with disabilities within policies and programming in Kenya," the statement said. "It is an issue that can be swept under the carpet and quickly forgotten, and unfortunately, it has become the responsibility of those working in the disability sector to continuously advocate for these issues without much success."

Since prompting criticism, the organization has stood by its campaign, tweeting, "Why is it so hard to accept the truth about the reality faced by women and girls with disabilities as they experience their menstruation?" 

Critics say rather than normalizing menstruation, the campaign stigmatizes it 

Bosire told Insider people who menstruate continue to face stigma, often causing low self-esteem in young girls, because periods are thought to be "dirty" and "disgusting."

"It's a completely normal reproductive function, but stigma surrounding menstrual health has always been about myths," she said. "You don't dispel these myths [about] menstruation by showing a girl with blood smeared on [her] face."

Bosire added that reactions to the ad illustrate why it's a problem. "People have been saying, 'This is disgusting,' and that's exactly what we're trying to fight when it comes to accepting menstruation as a normal process. Portraying this really just perpetuates the stigma," she said. 

Critics have also raised concerns of the ethics of using the young girl pictured in the ad to send the message. Bosire said it is exploitative to use a minor and someone with a disability to attract attention, and demeaning to portray her covered in menstrual blood since it implies she is also unhygienic or dirty. 

The accessibility of period products is a concern that needs to be addressed  

Bosire said a larger issue related to menstruation is that access to sanitary products is still a problem — menstrual cups may be more cost effective than purchasing pads or tampons, but they require reliable access to clean water in order to use them safely. 

People with disabilities face additional complications. For example, visually impaired people may have difficulty understanding how to use menstrual products without braille instructions, and physically-impaired people may lack the dexterity to use the products. 

Bosire said the conversation needs to be had, but in a different way. She noted that a recent ad campaign from Thinx, which envisions what would happen if men had periods, is a good example of the right way to raise awareness.

"Involving men and boys makes us think about the complexities of menstruation and the stigma, on that issue, and that messaging addresses social norms and behaviors," Bosire said. 

Read more: 

Your period could be more than 90% cheaper if you switch to menstrual cups, new research finds

Always is removing the female symbol from its menstrual products because not everyone who has a period is a woman

The World Cup-winning US women's soccer team tracked their periods for peak performance, and evidence shows everyday athletes can benefit from doing the same

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